Vol. 2, Issue 2, Part B (2025)

Food allergy is an emerging worldwide problem in childhood with serious consequences on food status, quality life, and health care use. Nevertheless, epidemiological data in low-resource environments, especially in conflict-prone areas of the Middle East is in urgent lack. To fill this evidence gap, this prospective cross-sectional study will be carried out in Al-Nu’maniyah General Hospital, Wasit Governorate, Iraq between January and June 2025. One hundred and eighty-two children between the age of under five years with symptoms indicative of food induced hypersensitivity were recruited. Modifications of National Institute of Health and Care Excellence (NICE, 2011) [15] criteria were used to establish clinical diagnosis, which was enhanced with caregiver-reported symptom diaries and, where possible, total serum IgE. Sociodemographic, feeding, family atopic history and environmental exposures data were gathered through a well-tested structured questionnaire. The intervention involved standardized first- line management of participants (allergen avoidance, oral antihistamines (cetirizine), and nutritional counseling), and clinical follow-ups at 4 and 8 weeks. Food allergy prevalence among this high-risk group of outpatients was 7.8% (95% CI: 5.410.2). The most common triggers were cow milk (42.3%), egg (28.1%), wheat (15.4%). Multivariate logistic regression was used to provide three independent predictors formula feeding initiated before age 6 months (adjusted odds ratio [aOR] = 2.71, 95% CI: 1.295.70, p =.008), a positive family history of atopic disease (aOR = 3.04, 95% CI: 1.526.09, p =.002), and rural residence (aOR = 1.92, 95% CI: 1 It is also important to note that 78.6% of the children diagnosed showed full recovery of the symptoms in 8 weeks of intervention. As these results emphasize, even resource-constrained settings can have positive results provided that early recognition and basic management principles are provided. The paper highlights the pressing need to use context-sensitive pediatric allergy protocols, to incorporate allergy screening into primary care, and community-level education on infant feeding behaviors in rural Iraq. These actions can be seen as being in line with WHO recommendation to reinforce child health systems in vulnerable environments and are associated with Sustainable Development Goal 3 (Good Health and Well-being).